Novel algorithm for quantitative assessment of left ventricular dyssynchrony with ECG-gated myocardial perfusion SPECT: useful technique for management of cardiac resynchronization therapy
Novel algorithm for quantitative assessment of left ventricular dyssynchrony with ECG-gated myocardial perfusion SPECT: useful technique for management of cardiac resynchronization therapy
复制标题
用心电门控心肌灌注 SPECT 定量评估左心室不同步的新算法：心脏再同步治疗管理的有用技术
作者：
K. Kiso;Akira Imoto;Y. Nishimura;H. Kanzaki;T. Noda;S. Kamakura;Y. Ishida
目的心脏再同步化治疗（CRT）是慢性和重度心力衰竭患者的既定治疗方法，据报道，左室（LV）非同步化的存在是预测该治疗阳性反应的最重要因素之一。在本研究中，我们开发了一种新的软件算法，用于定量评估ecg门控心肌灌注SPECT （GMPS）的左室非同步化，并评估其在CRT管理中的实用性。方法对33例慢性重型心力衰竭患者进行分析。分别于CRT前和CRT后6个月进行16帧/心周期的GMPS，用QGS软件计算左室舒张末期容积、收缩末期容积（LVESV）、射血分数（LVEF）。我们对16个连续计数值进行傅里叶变换拟合，生成4个心肌节段每心循环的时间-活动曲线，并测量每个节段从r波到最大计数点的时间[时间到收缩期结束（TES）]。对于左室不同步程度的评价，我们采用校正R-R时间的4节段TES最大差值（ΔTES）作为不同步指数（DI）。并将GMPS评价的基线DI与左室非同步化超声心动图指数进行比较；组织多普勒成像（TDI）评估最大时间与峰值速度之差（ΔTPV）。结果CRT前DI与LVEF、LVESV等左室功能有显著相关性（DI vs. LVEF, r = 0.57, P < 0.0001）。DI vs. LVESV；r = 0.64, P < 0.0001)。研究对象分为两组，LVEF升高> - 10%或LVESV降低> - 10%的反应组（R-Gp）和无反应组（NR-Gp）。CRT前R-Gp组DI明显高于NR-Gp组（25.9±22.2∶10.8±8.9,P = 0.01）。在R-Gp中，CRT后DI明显降低（25.9±22.2→13.6±10.9,P < 0.05）。GMPS测得的基线DI与TDI测得的基线ΔTPV显著相关（r = 0.38, P < 0.05）。结论该新算法可与TDI相媲美，可用于预测和评价CRT的疗效。
ObjectivesCardiac resynchronization therapy (CRT) is the established treatment for patients with chronic and severe heart failure, and it has been reported that the presence of left ventricular (LV) dyssynchrony is one of the most important factors which predict positive response of this therapy. In the present study, we developed new software algorithm for quantitative assessment of LV dyssynchrony from ECG-gated myocardial perfusion SPECT (GMPS), and evaluated its utility for the management of CRT.MethodsThirty-three patients with chronic severe heart failure were studied. GMPS was performed with 16 frame per-cardiac-cycle before and 6 months after CRT and LV end-diastolic volume, end-systolic volume (LVESV), ejection fraction (LVEF) were calculated by QGS software. We generated the time–activity curve per-cardiac-cycle in 4 myocardial segments by Fourier transform curve-fitting of the 16 serial count values, and measured the time from R-wave to the maximum-count point [time to end-systole (TES)] in each. For the evaluation of the degree of LV dyssynchrony, we used the maximum difference in TES (ΔTES) among the 4 segments which corrected for R–R time as dyssynchrony index (DI). Moreover, DI at baseline evaluated by GMPS was compared with the echocardiographic index of LV dyssynchrony; maximum difference of time to peak velocity (ΔTPV) evaluated by tissue Doppler imaging (TDI).ResultsDI before CRT showed a significant correlation with the LV function, such as LVEF, LVESV (DI vs. LVEF; r = 0.57, P < 0.0001. DI vs. LVESV; r = 0.64, P < 0.0001). The study subjects were divided into 2 groups, responder group (R-Gp) with LVEF increase >10% or LVESV decrease >10% and non-responder group (NR-Gp). DI before CRT was significantly larger in R-Gp than in NR-Gp (25.9 ± 22.2 vs. 10.8 ± 8.9, P = 0.01). In R-Gp, DI showed a significant decrease after CRT (25.9 ± 22.2 → 13.6 ± 10.9, P < 0.05). DI at baseline measured by GMPS correlated significantly with ΔTPV at baseline measured by TDI (r = 0.38, P < 0.05).ConclusionsThis new algorithm for the estimation of LV dyssynchrony might be comparable to TDI, and contributes to the prediction and the evaluation for the response of CRT.
DOI：
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发表时间：
1995-11
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
通讯作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
使用快速傅立叶变换近似确定计算收缩期壁增厚的准确性：基于犬和患者数据的模拟研究。
DOI：
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发表时间：
1994
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
Cooke,CD;Garcia,EV;Cullom,SJ;Faber,TL;Pettigrew,RI
通讯作者：
Pettigrew,RI
门控 SPECT 灌注图像的左心室功能和灌注：一种综合方法。
DOI：
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发表时间：
1999
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
Faber,TL;Cooke,CD;Folks,RD;Vansant,JP;Nichols,KJ;DePuey,EG;Pettigrew,RI;Garcia,EV
通讯作者：
Garcia,EV